FORM 1023-EZ for PLAINVIEW TAKEDOWN CLUB

Field Data
EIN 27-3127663
Case Number EO-2015141-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLAINVIEW TAKEDOWN CLUB
Organization’s Mailing Address 4040 ROLLING HILLS DR
City ARDMORE
State OK
ZIP 73401-9313
Accounting period End 12
Primary contact name DWAYNE ATENCIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DWAYNE ATENCIO
DIRECTOR
4040 ROLLING HILLS DR
ARDMORE OK 73401-9313

Officer/Director/Trustee Two

MITCH LUCAS
DIRECTOR
3921 ROLLING HILLS DR
ARDMORE OK 73401-9348

Officer/Director/Trustee Three

KERRI MILLER
DIRECTOR
84 GLENWAY ST
ARDMORE OK 73401-7780

Officer/Director/Trustee Four

VICKIE LUCAS
DIRECTOR
3921 ROLLING HILLS DR
ARDMORE OK 73401-9348

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2015
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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